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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004958
Report Date: 11/08/2022
Date Signed: 11/08/2022 03:02:05 PM

Document Has Been Signed on 11/08/2022 03:02 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MA, ZHIFANGFACILITY NUMBER:
414004958
ADMINISTRATOR:MA, ZHIFANGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 888-7301
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/08/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Zhifang (Catherine) MaTIME COMPLETED:
02:30 PM
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On November 08, 2022 at approximately 12:10pm, Licensing Program Analyst (LPA) Winnie Ly, conducted a scheduled Relocation Pre-Licensing inspection and met with Licensee Zhifang (Catherine) Ma. LPA and Licensee inspected the entire home for Health and Safety Hazards. Licensee owns this four bedrooms home and resides here with husband and two minor children. Per Licensee, facility operating hours are from Monday-Friday 8:00am-5:30pm.

Day Care Areas are on the ground level which consists of Livingroom, Large playroom, the kitchen, dining room, the bathroom and the backyard. Off Limit Areas are the entire upper level. Applicant’s CPR/First Aid expires 06/2024. Licensee has Completed Mandated Reporter Training. All required Immunization such as Influenza, Pertussis and Measles are on file.

Fire Clearance for the home has been granted on 11/07/2022 by the Redwood City Fire Department.

LPA observed the home is clean orderly and properly ventilated. Telephone service, heating, lighting and ventilation were evaluated. LPA observed a 2A10BC Fire extinguisher, operable smoke detector and carbon monoxide in the home. LPA observed no bodies of water in the home. Electrical outlets have child protective covers in place making them inaccessible to children. Chemical, detergents, cleaning compounds, medications, and other items of this nature are made inaccessible to children. Kitchen/Bathroom cabinets/drawers have child protective covers in place. Per Licensee, home does not have firearms or dangerous weapons.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MA, ZHIFANG
FACILITY NUMBER: 414004958
VISIT DATE: 11/08/2022
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Licensee was also informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPA discussed Child Abuse Mandated Training AB1207 with Licensee. As of January 1, 2018 all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

A copy of this report and appeal rights were discussed and left with Licensee whose signature on this form confirm receipt of reports. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm. Desk duty is available M-F, 8a.m.-5p.m., (650) 266-8800. Website for forms and Regulations: www.cdss.ca.gov

Large Family Child Care License is approved and will be effective as of today, 11/08/2022.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MA, ZHIFANG
FACILITY NUMBER: 414004958
VISIT DATE: 11/08/2022
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Home has age appropriate toys and equipment available for the children in care. Licenseee is reminded of NO walker, exersaucers, jumpers, bouncers and any similar items to be used for children in care. Those items shall be made inaccessible to children. Discipline policy was discussed with applicant.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022
LIC809 (FAS) - (06/04)
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